Outcome assessment in low back pain: how low can you go?

The present study examined the psychometric characteristics of a "core-set" of six individual questions (on pain, function, symptom-specific well-being, work disability, social disability and satisfaction) for use in low back pain (LBP) outcome assessment. A questionnaire booklet was admin...

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Bibliographic Details
Published in:European spine journal 2005-12, Vol.14 (10), p.1014-1026
Main Authors: Mannion, Anne F, Elfering, Achim, Staerkle, Ralph, Junge, Astrid, Grob, Dieter, Semmer, Norbert K, Jacobshagen, Nicola, Dvorak, Jiri, Boos, Norbert
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Low Back Pain - psychology
Low Back Pain - therapy
Male
Middle Aged
Outcome and Process Assessment (Health Care) - standards
Psychometrics
Quality of Life
Surveys and Questionnaires
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Summary:The present study examined the psychometric characteristics of a "core-set" of six individual questions (on pain, function, symptom-specific well-being, work disability, social disability and satisfaction) for use in low back pain (LBP) outcome assessment. A questionnaire booklet was administered to 277 German-speaking LBP patients with a range of common diagnoses, before and 6 months after surgical (N=187) or conservative (N=90) treatment. The core-set items were embedded in the booklet alongside validated 'reference' questionnaires: Likert scales for back/leg pain; Roland and Morris disability scale; WHO Quality of Life scale; Psychological General Well-Being Index. A further 45 patients with chronic LBP completed the booklet twice in 1-2 weeks. The minimal reliability (similar to Cronbach's alpha) for each core item was 0.42-0.78, increasing to 0.84 for a composite index score comprising all items plus an additional question on general well-being ('quality of life'). Floor or ceiling effects of 20-50% were observed for some items before surgery (function, symptom-specific well-being) and some items after it (disability, function). The intraclass correlation coefficient (ICC) ("test-retest reliability") was moderate to excellent (ICC, 0.67-0.95) for the individual core items and excellent (ICC, 0.91) for the composite index score. With the exception of "symptom-specific well-being", the correlations between each core item and its corresponding reference questionnaire ("validity") were between 0.61 and 0.79. Both the composite index and the individual items differentiated (P
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-005-0911-9